Second Time Overlooked in Crisis: Examining How HIV/AID Health Policies in the USA Connect with Policy Implications Today for Aging LGBTQ Adults During the COVID-19 Pandemic

Abstract

U.S. policy has, once again, overlooked the health care needs of older adults who are lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ). This population is estimated to more than double in the USA (Fredriksen-Goldsen, in Generations 38(4), 86–92, 2015 ), with estimates of approximately 3 million LGBTQ adults over 50 currently and 7 million by 2030 (Services and Advocacy for GBLT Elders in SAGE, New York, 2018 ). The healthcare model for addressing the needs of LGBTQ persons has historically been that of a disease model of care, particularly during the HIV/AIDS crisis, and has recently moved to that of a health equity model in the past 20 years. The LGBTQ community, social work profession, and general medical community worked to create the health care equity model we have today and this paper will discuss how this evolved. The health care equity model addresses the health needs for older adult LGBTQ populations. Older LGBTQ adults are more likely to experience elevated rates of chronic conditions (such as HIV, cancer, diabetes), higher prevalence of anxiety/depression, greater substance abuse, higher economic insecurities, limited community resources, and limited access to health care services compared to heterosexual/cisgender counterparts. This paper discusses how health disparities among this minority population and heterosexual/cisgender individuals have been exacerbated during the COVID-19 pandemic. Further, this paper will address policy, research, and practice implications to understand how to assist this vulnerable subpopulation of LGBTQ persons.

State of Cancer Care in America: Achieving Cancer Health Equity Among Sexual and Gender Minority Communities

“…Over the past several years, from the Orlando Pulse nightclub shooting in 2016 to the murder of George Floyd in 2020 and the 2021 Atlanta spa shootings, violence and discrimination against SGM, Black, Asian American, and Pacific Islander individuals has worsened longstanding health disparities in these communities, particularly in the midst of the COVID-19 pandemic. [3][4][5] Thus, national interest in SGM health equity accompanies a general interest in research, policy change, and education around diversity, equity, and inclusion, resulting from public concern over discrimination in health care against Black, Indigenous, and People of Color (BIPOC). Unfortunately, increased interest in SGM health equity has also been accompanied by a surge in discriminatory legislation directly affecting the SGM community, including legislative barriers to gender-affirming care.…”

Co-Creating Socio-Culturally-Appropriate Virtual Geriatric Care for Older Adults Living With HIV: A Community-Based Participatory, Intersectional Protocol

“…Intersectional demographics (race, sexual orientation, gender identity) and socioeconomic factors influence healthcare access and experiences for persons aging with HIV, and can be further barriers to accessing HIV-geriatric care. These factors may impact adherence to ART and failure to achieve viral suppression (Guaraldi & Rockwood, 2017) and other disparities in healthcare outcomes (Bietsch, 2022; Ecker et al, 2019; Williams et al, 2021). Health disparities among equity-deserving populations such as persons living with HIV have been further exacerbated during the COVID-19 pandemic (Alessi et al, 2023).…”